Ch5 mental status

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awhite152
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157103
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Ch5 mental status
Updated:
2012-06-03 19:18:47
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Jarvis Health Assessment Mental statusr
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Jarvis Ch5
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  1. Is mental status objective or subjective
    • BOTH
    • it's not directly observed, and it's inferred through an individual's behavior
  2. Consciousness
    Behing alert to one's own existence
  3. Affect
    state of mind, temporary expression of feelings
  4. Mood
    prolonged feelings displayed
  5. Orientation
    Person, place, time, event (x4)
  6. attention
    ability to concentrate/power of focus
  7. Aging adults and mental status
    • older adulthood contains more potential for losses
    • frief and despair around losses affect mental status: can result in disability, disorientation, or depression
    • chronic disease such as heart failure, diabetes and osteoporosis include fear of loss of life
  8. When to do a full mental health assessment?
    • Behavior change
    • Brain lesions (trauma, tumor, brain attack (CVA/TIA)
    • Aphasia (secondary to brain damage-suddenly can't speak)
    • Symptoms of psychiatric mental illness
    • ABCT abnormalities
  9. A,B,C,T abnormalities
    • appearance
    • behavior
    • cognition
    • thought processes
  10. dysthymia
    mild depression
  11. objective data about appearance
    • posture (slumped)
    • body movements (restless, pacing)
    • dress
    • grooming and hygiene
  12. Objective data about behavior
    • LOC
    • facial expression-appropriate to topic?
    • speech
    • mood and affect-how do you feel today? how do you usually feel?
  13. Objective data about cognitive functions
    • Orientation (x4)
    • attention span: ability to follow series of instructions
    • Recent memory: need to be able to corroborate
    • Remote memory: anniversaries, historic events
    • New Learning-4 unrelated words test (check at 5, 10, 30 min)-under 60 should get 3/4 right
    • Judgment-ask about future plans/family obligation
  14. Additional testing for person with aphasia
    • word comprehension
    • reading
    • writing
  15. Thought processes and perception objective data
    • though process-explain a sentence
    • though content-what they thought
    • perception-5 senses
    • **screen for suicidal thoughts**
  16. Mental status exam
    • J-Judgment: what would you do if you saw someone collapse in the street
    • O=Orientation: Name, location, date, time
    • M=memory: 3 unrelated words at 1 & 5 minutes, recent and past events
    • A=appearance: posture, body movements, dress, grooming/hygiene
    • C=Calculation: Subtract serial sevens from 100
    • S=speech: quality, rate, articulation, word choice
  17. Levels of consciousness
    • Alert
    • Lethargic
    • Obtunded
    • Stupor
    • Coma
  18. Alert
    A,A, O x4 (alert and oriented x4)
  19. Lethargic
    (somnolent)-drowsy, but responds to name, slow response, decreased spontaneous movements
  20. Obtunded
    difficult to arouse, confused, needs constant stimulation
  21. Stupor
    • or semi-coma
    • Unconscious but able to arouse with pain, language impaired, reflex activity
  22. Coma
    Unconscious, no response to pain
  23. Delirium vs. Dementia
    Delirium: acute onset, young or old, caused by infection, intoxication, withdrawal, hypoxia, fluid and electrolyte imbalance, post head trauma, postop; FIXABLE

    Dementia: gradual onset, more common in elderly, caused by Alzheimer's, Parkinson's, CVA, HIV, head trauma
  24. Dysphonia
    difficulty or discomfort in talking, with abnormal pitch or volume, due to laryngeal disease. Voice sounds hoarse or whispered, but articulation and language are intact
  25. Dysarthria
    Distorted speech sounds; speech may sound unintelligible; basic language (word choice, grammar, comprehension) intact
  26. Aphasia
    True language disturbance, defect in word choice and grammar or defect in comprehension; defect is in higher integrative language processing
  27. Abnormalities of mood and affect
    • Flat affect
    • Depression
    • Depersonalization
    • Elation
    • Euphoria
    • Anxiety
    • Fear
    • Irritability
    • Rage
    • Ambivalence
    • Lability
    • Inappropriate affect
  28. Developmental Considerations for Aging adult
    • *No decrease in knowledge or vocab
    • Slowed response time
    • Decrease in recent memory
    • No change in remote memory
    • Multiple losses can affect mental status and cause disorientation, depression and disability
    • Check sensory status, vision and hearing before any aspect of mental status
    • Follow same ABCT guidelines with these additional considerations: B: LOC; C: orientation, new learning
  29. What is the most basic function tested first in a mental status exam?
    consciousness

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